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Changes in Heart Failure Symptoms are Associated With Changes in Health-related Quality of Life Over 12 Months in Patients With Heart Failure

Heo, Seongkum, PhD, RN; Moser, Debra K., PhD, RN, FAAN; Lennie, Terry A., PhD, RN; Fischer, Mary, MSN, RN; Kim, JinShil, PhD, RN; Lee, Mikyoung, PhD, RN; Walsh, Mary N., MD; Ounpraseuth, Songthip, PhD

doi: 10.1097/JCN.0000000000000493
ARTICLES: Heart Failure

Purpose: Patients with heart failure (HF) have notably poor health-related quality of life (HRQOL). A 5-point improvement in HRQOL is associated with reduction in hospitalization and mortality rates. Heart failure symptoms are associated with poor HRQOL, but little is known about whether changes in HF symptoms lead to changes in HRQOL over time. Therefore, we examined the association of changes in HF symptoms with changes in overall, physical, and emotional aspects of HRQOL over a 12-month period, controlling for typical covariates.

Methods: Data on HF symptoms and HRQOL (Minnesota Living Heart Failure questionnaire) were collected from 94 patients with HF (mean age, 58 years; 58.5% female) at baseline and 12-month follow-up. Psychosocial factors (depressive symptoms, perceived control, and social support), behavioral factors (medication adherence and sodium intake), sociodemographic and clinical factors (age, comorbidities, and body mass index), and a physical factor (functional status) were collected at baseline. Multiple and logistic regression analyses were used to analyze the data.

Results: In complete models, changes in HF symptoms were associated with changes in the total HRQOL (P < .001) and the physical (P < .001) and emotional (P < .001) aspects of HRQOL over 12 months, controlling for all the factors. Changes in HF symptoms were significantly associated with the likelihood of at least a 5-point improvement in HRQOL (P = .001), controlling for covariates.

Conclusions: Improvement in HF symptoms was associated with improvement in HRQOL over 12 months. Thus, development and delivery of interventions that target improvement in HF symptoms may improve HRQOL.

Seongkum Heo, PhD, RN Associate Professor, College of Nursing, University of Arkansas for Medical Sciences, Little Rock.

Debra K. Moser, PhD, RN, FAAN Professor, College of Nursing, University of Kentucky, Lexington.

Terry A. Lennie, PhD, RN Professor, College of Nursing, University of Kentucky, Lexington.

Mary Fischer, MSN, RN Clinical Nurse Specialist, St Vincent Hospital, Indianapolis, IN.

JinShil Kim, PhD, RN Professor, College of Nursing, Gachon University, Incheon, South Korea.

Mikyoung Lee, PhD, RN Associate Professor, College of Nursing, Texas Woman’s University, Denton.

Mary N. Walsh, MD Cardiologist, St Vincent Hospital, Indianapolis, IN.

Songthip Ounpraseuth, PhD College of Public Health, University of Arkansas for Medical Sciences, Little Rock.

The article was edited by the Office of Grants and Scientific Publications at the University of Arkansas for Medical Sciences.

Funding for this study came from the American Heart Association, Scientific Development Grant (0830104N) to S.H.

The authors have no conflicts of interest to disclose.

Correspondence Seongkum Heo, PhD, RN, College of Nursing, University of Arkansas for Medical Sciences, 4301 W Markham St, Slot #529, Little Rock, AR 72205 (sheo@uams.edu).

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